HCPCS Level II Code Set Update: New, Revised, and Deleted Codes

Discover the October HCPCS Level II Code Set Update: October 2024 HCPCS Level II code set will receive a quarterly update, introducing 32 new drug and biological codes. Additionally, five codes will be deleted, and five others will undergo revisions. Let’s explore what’s in store.

New HCPCS Level II Codes

The Centers for Medicare & Medicaid Services (CMS) recently released the anticipated quarterly update files for drugs and biologicals on their website. Effective October 1, these new codes will be available, with the exception of CPT® 90684, which became effective on June 17

Source: New Drug and Biological Codes Go into Effect Oct. 1

Understanding the New October 2024 HCPCS Level II Codes:

Many of the recently introduced October 2024 HCPCS Level II codes were proposed by stakeholders during CMS’ second quarter 2024 Drug and Biological Code Application Review process. This overview provides insights based on the application summaries and CMS’ coding recommendations.

Imaging:

• A9610: This code represents the preparation, measurement, and administration of XENOVIEW, an inhaled hyperpolarized contrast agent used in magnetic resonance imaging. It replaces C9791 for services provided in inpatient, outpatient, or ambulatory surgical settings.

Injections and Infusions:

• J0138 (COMBOGESIC® IV): This code is for an intravenous injection of acetaminophen and ibuprofen, approved for adults needing relief from mild to moderate pain or as an adjunct to opioid analgesics.
• J0175 (KISUNLA™): This code is for an amyloid beta-directed antibody used to treat Alzheimer’s disease.
• J1749 (AURLUMYN™): This code is for a drug used to treat severe frostbite.
• J2601 (Vasopressin): This code is for a drug used to increase blood pressure in adults with vasodilatory shock.
• J9329 (TEVIMBRA): This code is for a drug used to treat esophageal squamous cell carcinoma.

Biosimilars:

• Q5135 (TYENNE®): This code is for a drug used to treat rheumatoid arthritis and juvenile idiopathic arthritis.
• Q5136 (JUBBONTI and WYOST): These codes are for biosimilars used to treat osteoporosis or prevent bone fractures in cancer patients.

Wound Covers:

• Q4334-Q4345: These codes are for various allografts and synthetic wound coverings, including amniotic membrane, collagen, and other materials.

Revised Codes for Drugs and Biologics:

The revised drug and biological codes and their corresponding effective dates are presented below

Source: New Drug and Biological Codes Go into Effect Oct. 1

Deleted HCPCS Level II Codes:

The following five drug and biological codes are scheduled for deletion as of Sept. 30.

Source: New Drug and Biological Codes Go into Effect Oct. 1

Teva Pharmaceuticals’ paclitaxel product, previously known as J9258, is now classified as a generic version of ABRAXANE®. It will be billed using the existing HCPCS Level II code J9264.

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